Week 1 Flashcards
(36 cards)
a1/a2/b1/b2/b3
tissues?
response
a2 antagonist targets
CNS Pontomedullary Region - increase NE (BP up)
Periphery - increase release NE from nerve endings presynaptic a2
Phenoxybenzamine
Effect
Side effects
Halflife
Use
Block alpha irreversibly leading to drop in PVR and baroreflex response. Tachy might be increased by a2 block in CNS.
Hypotension, reflex tachycardia, @ higher levels inhibits irreversible respnses to serotonin, histamine, and ACh, nasal stuffiness, miosis, sex dysfunction (imparied ejaculation)
24 hours (impact is longer as receptors need to regenerate)
Pheno, surgery for pheno, PBH
Phentolamine
GI effect
Use
side effects
Stimulates GI smooth muscles and enhances gastric acid secretion
Pheno - short term control, pseudo-onbstruction of bowel, limit dental necrosis, raynauds, rapid withdrawal of clonidine, the ingestion of Tyramine-rich food during the use of non-selective inhibitors of MAO
impaired erection in men, hypotension, reflex tachy, MI, GI stimulation (watch out for peptic ulcers)
Prazosin
other functions
affecting heart rate
members to treat BPH
Half life
use
side effects
Tamsulosin
inhibitors of PDE, favorable effects on lipids
no
Tetrazosin, Doxazosin
2-3 hours longer in CHF patients
hypertension, CHF, BPH (down smooth muscle)
hypotension, syncope
no effect on BP
beta blockers
short term effect
b1 vs. non-sec b
effect on heart
CO and PR increase (b2)
b1 greater fall in PR
lower automaticity, lower conduction, increased refreactory perioid (PLB)
β blockers are considered (class)
II
decrease class II and O2 comsumption
Local anasthetic effect mediation
Na+ channel
Effect of beta blockers on (b1)
BP
CO
other mechanism?
decrease BP (esp long term)
decrease CO
decrease b1 -mediated renin release (lower PR)
side effect of beta blockers in
COPD
diabetes
effect of insulin
adipose
lipids
brnchoconstriction
catecholamines promote glycogenolysis (DM1)
decreased by beta blockers
lower release of fatty acids from adipose
lower HDL, higher LDL, higher Triglyceride
beta blockes use
Essential Hypertension
Angina Pectoris
Arrhythmias
Glaucoma
Post-MI Therapy
Congestive Heart Failure (all grades
beta blockers contraindications
COPD
Conduction distrubance (brady)
Hypoglycemia
Rapid withdrawal
1st generation beta blockers
Propranolol
Timolol
Pindolol
2nd gen beta blockers
metroprolol
atenolol
acebutolol
esmolol
3r gen beta blockers
sotalol
Carvedilol
labetalol
intrinsic beta activity
pindolol
acetabutolol
labetalol
membrane stabilizing activity beta blockers
propranolol
acetabutolol
carvediolol
beta blockers blocking a
labetolol 5-10 fold b>a
carvedilol 1.5 fold b>a
beta blockers blocking postassium channel
sotalol
vasodilator besides beta blocker
labetaolol
carvedilol
beta blocker for HT when very compromised IV
Esmolol(SVT, VT)
beta blockers comibined with diuretic
Atenolol
Specific use of pindolol
Arrythmias with reduced cardiac reserve
Specific Use of timolol
Open Angle Glaucoma
